Recovering from Rotator Cuff Injuries

For active people with rotator cuff injuries, the most commonly asked question is whether or not the injury will heal without need for surgery. In 2012 the American Academy of Orthopaedic Surgeons revealed studies reporting that surgical repair fails in about 57% of rotator cuff cases. Non-surgical treatment of rotator cuff injury succeeds in about 50% of cases. It seems, then, that opting first for a non-invasive method has just as much potential for success as surgery.

Anatomy Of An Injury

Rotator cuff injury is common because the four major muscles involved in rotating the arm in the shoulder socket are used frequently every day. Each time a person moves their arm they are using their rotator cuff. The “cuff” is created by muscles surrounding the shoulder blade, working together to form a cuff of tendons that cover the top portion of the arm bone as it enters into the shoulder socket. The cuff serves to keep the ball of the arm bone properly positioned within the socket.

Lifting is the most common action that will become painful with a rotator cuff injury. You may feel pain as muscle tissue of the rotator cuff is pinched between the bones of the ball and socket joint. This condition may sometimes be commonly called bursitis. Rotator cuff pain becomes more likely in active adults as they age due to the normal effects of wear and tear or repetitive movement. Just as a rope will fray if constantly rubbing against a sharp edge, the tendons of the cuff will also eventually wear and possibly tear. Symptoms are usually noticeable as:

  • Sharp pain down the side of the arm when reaching upward or behind.
  • Throbbing pain at night during sleep.
  • Pattern of pain across the shoulder and down the arm.

Non-Surgical Options

Physical therapy may be the first recommendation by a physician. In addition to a method of treatment, there are also many things an individual can do outside of a physical therapy environment to aid in recovery.

Rest: Rest the rotator cuff by limiting range of motion, especially overhead reaching.

Support: Compression wear is available with devices designed to specifically support the shoulder and rotator cuff. Often called a sling or sleeve, many have designs that integrate heat and ice therapies that further help to reduce inflammation and pain as well as accelerate healing.

OTC Medication: Non-prescription drugs like ibuprofen or naproxen can help reduce swelling and manage pain.

Exercise: It is important to continue to strengthen the affected shoulder and maintain flexibility. However, exercises and stretches should be adapted so as not to further exacerbate an injured rotator cuff that is in recovery.

Flexibility Exercises

Crossover Reach Stretch

  1. Standing or sitting, raise affected arm chest high and reach across the chest.
  2. Using the opposite hand, apply gentle pressure just below the elbow and hold for about 30 seconds.
  3. Switch arms and repeat.

Back Hand Clasp Stretch

  1. Clasp both hands behind you with arms lowered.
  2. Slowly raise clasped hands as long is it does not cause pain. Hold for 30 seconds.
  3. Release hands and relax for 10 seconds then repeat stretch.

Strengthening Exercises

When using weights in exercises to improve strength, select a weight that will not cause pain during use.

Pendulum Swings

  1. Using a table for support, lean over with one forearm resting on the table top, back parallel to the floor, and dumbbell in the other hand hanging straight down.
  2. Gently swing dumbbell back and forth for 30 seconds.
  3. Switch arms and repeat.

Therapy Goals

Treatment approaches for rotator cuff injuries should have in mind multiple goals:

  • Healing the injury.
  • Managing pain.
  • Maintaining range of motion.
  • Moderate immobilization with compression wear and limiting movement will help accelerate healing of the affected muscles. Proper use of ice, heat and over-the-counter medications can give a person pain management options within their control. Commitment to a regular stretching and exercise program will help to prevent atrophy of the affected muscle while waiting for the injury to heal.

    A person does not have to be a professional athlete to experience a painful rotator cuff injury. Such an injury can occur just through the normal effects of aging and the everyday activities a person engages in. Pain from rotator cuff injuries can stay with a person for years. It is also very common to have a repeat performance of injury after a prior injury has healed. That is why once the problem arises it is important for any sufferer of rotator cuff injury to modify their lifestyle to include habits and methods that are pro-active in maintaining rotator cuff health. Don’t perform the recommended flexibility and strengthening exercises only after an injury occurs, make them a regular part of your daily health regimen.

    Also keep in mind that healing properly from a rotator cuff injury can take a very long time. Be patient and stay committed to your physical therapist’s advice on how to care for your injury. For more information regarding rotator cuff health and injury recovery, consult medical experts who are committed to non-surgical approaches first.

Rotator Cuff Recovery Tips

A rotator cuff tear is a common and serious injury. To fully recover from this type of injury it is vital to go through proper rehabilitation. The goal is to strengthen these muscles while not overworking them. Due to the complicated nature of the shoulder joint, it is best to seek the help of a professional when working through your rehabilitation.

The Rotator Cuff Muscles

First, it is important to understand what this injury is, so you know how it will be treated.

The anatomy of your shoulder looks like this; the ball of your shoulder sits in a very shallow socket created by your shoulder blade and collar bone. Holding this ball into the socket and keeping it stable are four muscles called the "rotator cuff". This rotator cuff is made up of the supraspinatus, infraspinatus, teres minor, and subscapularis. These muscles provide stability while also allowing for a wide range of mobility.

If you have a "tear" of the rotator cuff then you have torn through one or more of these muscles or tendons. Each person is different but some of the typical signs and symptoms of a rotator cuff tear are as follows:

First would be pain. You should not have shoulder pain as it is not normal and should not be ignored. It warns you that there is something wrong and will continue to get worse unless addressed. Although pain is present, it doesn't always mean that a tear is present as well. A muscle or tendon strain, tendonitis, or bicep issue could also be the culprit. However, these issues can lead to tears in your rotator cuff if left untreated, so be sure not to overwork with pain.

Swelling can also be present with a rotator cuff tear, so if your shoulder is swollen, you should seek medical attention. Another sign would be a loss of motion. If you are unable to raise your arm as high as you were before the pain, then chances are there could be something wrong.

Important Notes

When recovering from this type of injury, you are trying to strengthen these muscles while not over stressing them. You will also be working on regaining as much range of motion as possible. These two factors will make this unlike any workout you have had before. You are not working on building big muscles, like in a regular workout, but working toward stability and flexibility.

You should always consult your doctor or physical therapist about any shoulder injury that you may have. It is your therapist's job to put you through a routine that is suited best for you. It is very important to realize that going beyond what is recommended could hinder your recovery time or worsen your injury in general.

When you begin rehabbing you shoulder, you will most likely begin working with light weights because you are now focused on stability and flexibility. This will cause less fatigue then you may be used to with regular workout. That is OK! The goal is to strengthen, stabilize and regain motion without overdoing it with heavy weight and pain. Each exercise will have a specific amount of repetitions that you will go through. Consult with your therapist regarding these repetitions and exercises.

Keep These in Mind

There are a few important things to keep in mind when working out your shoulder:

  • Don't overdo it with heavy weights. You do not want to lift something that your shoulder isn't able to handle. Make sure to consult your therapist.
  • Important to warm up the shoulder before beginning strength training. Follow your therapist's specific warm up routine.
  • Don't get frustrated during these workouts. These injuries take time to heal and it will take time to return to previous form.
  • Ice will help after workouts to reduce swelling and help your shoulder heal properly.
  • Make sure to give your shoulder the rest it needs. Don't overdo it with unnecessary activity. Avoid any sports or strenuous activity until you are fully healed. If you are unsure, consult your therapist.
  • If you are looking for a more intense workout, you are still able to work lower body. Just be sure to avoid stress to the shoulder as your therapist recommends.

Injured rotator cuffs are serious injuries, but it's not one that you can't recover from with the right therapy and pace. Remember, shoulder rehabilitation takes time and it is important to give your shoulder the proper time it needs. Always consult your doctor or therapist before trying anything on your own, because the last thing you want is to make things worse for yourself.

The Top 3 Secrets Revealed to Minimize Your Fall Risk!

  1. Find out if you have a balance problem
    Are you falling or tripping more often? Do you feel like you rely on a friend or furniture to walk safely from one place to another? Have you changed your normal lifestyle to accommodate the fear of a potential fall? If you have answered yes to any of those questions, you may have a balance problem. Balance is dynamic. There are several component parts that contribute to balance such as the musculoskeletal system, the somatosensory system, the vestibular system, and the neuromuscular system. All systems play an equal role in contributing to someone's overall stability. It is absolutely necessary to determine which system(s) are impacting your balance to appropriately treat and find optimal outcomes. You can determine which systems are impacting your balance by contacting your doctor or physical therapist.
  2. Safety First
    The next step in reducing your potential for falling is to review your home to ensure that it is environmentally safe? Do you have throw rugs throughout your home? Do you have limited lighting in your hallways and walkways at night? Do you have staircases without handrails on either side? Do you have excessive clutter throughout the rooms in your house? If you have answered "yes" to any of these questions, then you may be at risk for falling from environmental hazards. Modifying your environment is a quick and easy way to decrease ones fall risk and improve someone's safety in the home. Eliminate obstacles, such as scatter rugs, clutter, and phone and electrical cords. Install handrails on stairs and grab bars near toilets and bathtubs. Install non-skid strips in bathtubs and showers and use only non-skid bath mats. Keep items you use often in cabinets you can reach easily without using a step stool. Another important step in safety is to review your daily activities. You certainly don't want to restrict your activities, but you should be aware of activities that may put you at risk. This includes rising quickly from a lying or seated position to standing.
  3. Take charge of your physical condition
    Take charge of your physical condition by exercising regularly (always consult with your doctor before starting a new exercise program) and getting regular physicals. Keep your eyeglass prescriptions updated with regular eye exams. Poor vision can increase someone's fall risk.  Be aware and monitor any side effects your medications. Many medications are known to cause dizziness or even fatigue, both of which can increase your risk for falling. You should not limit your participation in health activities or regular exercise. Ironically, inactivity itself can increase your risk for falling. Prolonged inactivity can decrease muscle strength and flexibility. In addition, it can decrease your ability to react to sudden changes in your environment, such as a slippery floor or uneven surfaces outside. By remaining active in your daily life, you maintain your strength, flexibility and coordination, as well as your ability to keep your balance in a variety of conditions. More importantly, act now! Stop making excuses on why you have balance problems. Do not wait until you fall. Take charge of your physical condition and your surroundings. If you notice that you are unable to confidently perform certain daily tasks, you are falling or tripping more frequently, and/or you are experiencing symptoms of dizziness you should contact your doctor or physical therapist for an appointment to discuss your symptoms.

How to Take Charge of your Balance!

Everything you do in your daily life, whether for daily living, work, or fun requires balance. Walking, getting up from a chair, cleaning the house, and reaching in the cupboard are all activities that require balance. All of these tasks require balance control but should be automatic processes that require minimal attention to balance. However, when there is a balance problem, these processes are no longer automatic and take conscious effort. It can cause disruptions in your daily routine and increase you risk for falls.

What is balance?
Balance is a complex process that depends on three components:

  1. Sensory systems to communicate incoming information about our body and its relationship to the environment around you
  2. Your brain to process this incoming information
  3. Your muscles and joints for coordinating the movements required to respond to the brain's interpretation to sensory input

Balance control is accomplished without requiring our conscious attention. When there are balance deficits, we have to exert conscious effort to try to overcome obstacles and complete daily tasks. It can result in fatigue, shortened attention span, and reduce a person's ability to complete several tasks at once.

Loss of balance
In a normal healthy individual, the three senses of vision, hearing, and touch work together to perceive where the body and head are in space. They provide information about the environment around us.  These sensory systems communicate with the brain to ensure optimal stability. When a person has a balance disorder, one may have a problem in any one of these systems or multiple systems. The risk of developing one or more of these problems increases with age due to potential degenerative changes that occur over time, infectious diseases, and/or the effects of injuries accumulated over a lifetime.

Identify, treat, and improve balance
Balance can improve and fall risk can reduce! Although age, past medical history, and medical conditions play a role in someone's overall balance, it does not limit them from improving balance. Balance is quickly learned and improved when practiced. The key component of improving one's balance is understanding what component part of balance is compromised. Because of the complexity of balance control, not all balance problems are the same. Determining the cause of a balance disorder and what treatment options are the most appropriate can be difficult. However, there have been significant advances in evaluation and treatment approaches for balance disorders that have proven to be highly effective and offer relief to those suffering from imbalance or dizziness. There are also medical professionals and clinicians who are specially trained to apply these evaluation and treatment methods.

It is not uncommon for individuals with a history of balance problems to regain their balance control through accurate diagnosis followed by specific medical treatment and/or rehabilitation exercises. Balance can be practiced, balance can improve, and fall risk can decrease!

Don’t Ignore your Dizziness!

Dizziness is a term that is used for a variety of sensations that can mean different things to different people. Spinning, wobbly, unsteady, and lightheaded are some of the few words people use to describe their dizziness.

Dizziness can be caused by a number of different factors. One potential cause of dizziness includes a problem within the balance control mechanism. For example, vertigo can be caused by a disturbance in a particular part of the inner ear - the vestibular system. The number one symptom with vertigo is spinning. The vestibular system provides your brain with information about your head in relation to gravity. When there is miscommunication between your inner ear and your brain, the result may be dizziness, vertigo (spinning), imbalance, disorientation and possibly nausea and vomiting.

Vertigo is not the only cause of dizziness. There are several other reasons why someone may feel dizzy. However, no matter what the cause, dizziness is a symptom that can be treated when appropriately diagnosed. Diagnosing takes the appropriate clinical examination to determine the cause of your symptoms. When diagnosed, appropriate treatment can resolve your dizziness.

Do not IGNORE your symptoms of dizziness. Several people mistaken dizziness for the normal aging progress, hormonal imbalance, or make excuses and blame their symptoms on their imagination. The truth is, none of these statements are accurate.

It is important to seek medical attention from your doctor and/or physical therapist to discuss your symptoms of dizziness.

What is Lumbar Stenosis?

Lumbar Spinal Stenosis. Big words for an unbelievably common problem. Lumbar spinal stenosis is a condition affecting the lower back where the spinal cord one or more of the vertebral foramina become narrowed due to one of several causes. It is painful and causes pain, weakness, and numbness in the lower extremities. Read on to learn more about this condition.

What exactly is this condition?
The lumbar area is the lower back, specifically made up of five vertebrae in the lower back area. The spinal cord runs through the spinal canal and nerves come off the spinal cord and exit through small openings in the vertebrae called foramina. These nerves control the sensations and movement in the lower extremities – buttocks, legs, toes, etc. Sometimes, the spinal canal or the vertebral foramina narrow and begin to put pressure on the spinal cord and the nerves. This causes pain, numbness, and weakness possibly diagnosed as lumbar spinal stenosis.

What causes lumbar spinal stenosis?
According to the Mayo Clinic, some people are born with a small spinal canal, but most spinal stenosis occurs when something happens to reduce the amount of space the spinal cord or the nerves have available. It is most commonly diagnosed in people over the age of 50. Some causes are:

  • Overgrowth of bone – wear and tear on the bones of the spinal column can sometimes cause osteoarthritis to develop and bone spurs to grow into the spinal canal. This is the leading cause of lumbar spinal stenosis.
  • Herniated disks – the disks between the vertebrae wear out with age and compress. As this happens, some of the material inside the disk runs out and into the spinal column putting pressure on the spine.
  • Thickened ligaments – the ligaments that hold the bones together may thicken over time and begin to bulge into the spinal canal.
  • Tumors – benign or cancerous abnormal growths occur within and along the spinal canal and membranes, putting pressure on the spinal cord and nerves.
  • Injuries – injuries from accidents or even swelling of tissue after back surgery can put pressure on the spinal cord and nerves.

What are the symptoms?
Symptoms of lumbar spinal stenosis are typically pain or cramping in the legs and buttocks, especially after walking or standing. Often sufferers have numbness or weakness of the lower extremities. The pain is usually relieved by sitting down or even bending over. The symptoms may mimic other disease states such as sciatica, diabetic neuropathy, or peripheral vascular disease. The symptoms often continue to worsen over time and even lead to a loss of bowel and bladder control. It is very important if you have persistent pain, numbness, or weakness in your back, legs or arms to visit your doctor to find out the cause and seek treatment.

How is lumbar spinal stenosis diagnosed?
Your physical therapist will diagnose the disease by first discussing the symptoms and medical history, including how long the symptoms have been present and when they are better or worse. Next is the physical exam including assessment of range of motion of the back and the legs.

Are there treatments for lumbar spinal stenosis?
In most cases, patients with lower back pain and sciatica due to spinal stenosis can recover without medications, injections, or surgery. This is where a thorough evaluation from a therapist trained in hands-on manual therapy is crucial. He'll be able to determine specifically which muscles and joints in your spine need to be worked specifically with the skilled use of his hands.

Another thing we see is that it's common for people who have spinal stenosis to limit their activities which leads to weakness and often more pain. Physical therapy can help to strengthen muscles and improve endurance. It can help develop and maintain flexibility of the spine and it can help improve balance that may have been lost while suffering with pain and discomfort.

In most cases, patients need not worsen to the point where they would need surgery. Although some less invasive procedures have been developed in recent years, however, there are always risks with any surgery so your doctor will discuss the options and weigh the risks and benefits with you to allow you to make an informed decision.

Can it be prevented or treated at home?
Unfortunately, because it is a degenerative disease, lumbar spinal stenosis cannot be prevented. It is often just a normal part of the aging process, but exercising and physical therapy can often minimize the symptoms and limit progression of the disease. Outlook for recovery depends on the severity and duration of symptoms when it is first diagnosed as well as response to conservative treatments.

Home treatments include applying hot or cold packs, performing prescribes exercises, maintaining a healthy weight and using a cane or walker when necessary to reduce the stress applied to the lumbar area or provide relief from pain.

If you or a loved one has been diagnosed with lumbar spinal stenosis, the professionals at Hess Physical Therapy  are here to help with your therapy needs. Contact us to help you get started on the road to recovery.

Are You Suffering From Sacroiliac Joint Pain?

Many people have never heard of the sacroiliac (SI) joints and have no idea of where they are or what their function is within the body. But those who suffer from sacroiliac joint pain are all too familiar with the joints themselves and the pain caused when something goes wrong with them.

Where Are the Sacroiliac Joints?

If you look at the word "sacroiliac", you'll see that it describes two areas in the body:

  • "Sacro" sounds a little like "sacrum", which is a triangular-shaped bone in the lower part of the spine, centrally located just below the lumbar spine. The sacrum, unlike most of the spine, is not mobile. It's made up of five vertebrae that are fused together.
  • "Iliac", the second part of the word, refers to the two large bones (ileum) that make up the pelvis.

The target="_blank"sacroiliac joints, or SI, are what connect the spine to the pelvis. The sacrum and the illiac bones are held together by a group of strong ligaments. There is very little motion at these joints. Most of the motion in the area around the pelvis is either facilitated by the hips or the lumbar spine. The joints act primarily as shock absorbing structures.

There are numerous terms for pain in the SI joints, including SI joint dysfunction, SI joint syndrome, SI joint strain or inflammation. All refer to a condition that causes pain in the SI joints stemming from different causes.

Causes of Sacroiliac Joint Dysfunction

As with most joints in the body, the SI joints are covered by a protective layer of cartilage. When this cartilage is either damaged or worn away, the bones begin to rub against each other, eventually causing degenerative arthritis (sometimes known as "osteoarthritis") to develop.

Aside from aging, one common cause of SI dysfunction is pregnancy. Hormones released during pregnancy allow the ligaments to relax, allowing for more movement in preparation for childbirth. The increased movement in the joints can and often does cause increased stresses and abnormal wear. In fact, any condition that changes the normal walking pattern puts stress on the SI joints that can lead to pain. This might be one leg that's longer than the other, or pain in another joint such as the hip, knee or ankle, that causes a change in the way a person walks.

It's not only too much movement in the SI joints, that can cause problems — too little movement (hypomobility or fixation), can also lead to pain. The area where a person feels pain depends on whether the problem is caused by too much motion in the SI joints (hypermobility), or too little:

  • Too much movement typically causes pain in the lower back or hip area which sometimes radiates in the groin area.
  • Too little movement usually results in pain on one side of the lower back or buttocks which sometimes radiates down the leg (similar to the pain of sciatica).

Other disorders that affect the body's joints can sometimes cause pain in the SI joints. These include:

  • gout
  • rheumatoid or psoriatic arthritis
  • reactive arthritis
  • ankylosing spondylitis (a form of inflammatory arthritis that always affects the SI joints)

Symptoms of an SI Disorder

As mentioned, a problem with the SI joints causes symptoms ranging from lower back, hips, buttocks, groin and legs. The pain is usually worse with prolonged sitting, rolling in bed, getting in and out of bed, getting in and out of the car. Sometimes, there may also be stiffness in the SI joints and a burning sensation in the pelvis.

Diagnosing Sacroiliac Dysfunction

The first step in diagnosing a problem with the SI joints, is gathering a medical history and performing a physical exam. The physical therapist will ask questions to try to ascertain whether there are any underlying disorders that could be causing a patient's pain. Because there are other conditions that can produce similar symptoms, it's basically a process of elimination that helps narrow down the diagnosis.

Certain "signs" can also help the doctor differentiate SI pain from pain coming from other sources such as the lumbar spine or the hips. Various tests can be performed during the physical that can help pinpoint or isolate the source of the pain. Putting the hips and legs in certain positions and then applying pressure can move or apply pressure to the SI joints to determine if they're what's causing the pain. In other words, the physical therapist actually tries to "provoke" pain in the SI joints.

Treatment Options

Physical therapy is often very useful in treating SI joint pain. A physical therapist will prescribe exercises and stretches that can often go a long way toward providing significant pain relief.

What's even more helpful is a specialty field in physical therapy called manual therapy. It's form of therapy where the physical therapist uses skilled techniques learned through additional training that helps move the pelvis and the spine, and optimize the condition of the muscles surrounding the sacroiliac joints.

But it all starts with a thorough and comprehensive physical examination. A good evaluation lays the foundation for successful treatment.

Lumbar disc herniation: What is a slipped disc?

What is a disc?

The spine is composed of 33 vertebrae, or bones, that are stacked on top of each other giving us our upright posture. It is in between 24 of these vertebra that a piece of cartilage, or intervertebral disc, lies to provide cushion to the spaces between each bone.

Intervertebral discs are often described as “jelly donuts”. The outer portion of the disc, rubbery in substance, is the annulus fibrosus. The inner portion of the disc acting to “fill the hole” of the donut is a gelatin-like substance, the nucleus pulposus.

A healthy disc is soft, flexible, and helps to absorb shock and the daily forces that act on the spine.

What is a herniated disc?

When abnormal or increased stress is applied to the spine, the outer and much tougher part of the disc, the annulus fibrosus can tear. As a result, the gelatin-like nucleus pulposus can then leak through the tear. This “leak” or “bulge” of the disc is referred to as a herniated disc.

This herniation, often mistakenly referred to as a “slipped disc” can be caused by direct trauma or long term pressure on the spine.

How does it feel?

Symptoms of a herniated disc may result in pain, numbness, tingling or weakness in the neck, back, arms or legs. The type and location of symptoms experienced depend on the location and the direction of the herniation. Additionally, if the “bulging” or “leaking” disc pushes on a nearby nerve, muscle weakness or pain may occur. If it is not in contact with a nerve, the individual could even remain asymptomatic and the condition may go undiagnosed.

The following symptoms may be reported with a disc herniation:

  • Pain in the neck, back, low back, arms or legs
  • Inability to bend or rotate the neck/back
  • Numbness or tingling in the neck, shoulders, arms, hands, hips, legs, or feet
  • Weakness in the arms or legs
  • Limping when walking
  • Increased pain when coughing, sneezing, reaching or sitting
  • Inability to stand up straight; forward or leaning posture
  • Difficulty getting up from a chair
  • Inability to assume one position for a long period of time
  • Pain that is worse in the morning

How can I prevent a herniation?

To help prevent experiencing a herniated disc, the following measures should be taken:

  • Use proper body mechanics when lifting, pulling, pushing, or participating in any activity that puts increased stress on the spine
    • If you are unsure of proper body mechanics and positioning, see a physical therapist to learn more
  • Maintain a healthy weight and active lifestyle
    • Keep your muscles strong and flexible
    • Participate in consistent physical activity to promote a healthy fitness level
  • Stop smoking
    • Researchers believe smoking damages the discs by lessening the supply of oxygen leading to faster disc degeneration

Can physical therapy help a herniated disc?

In all but the most extreme cases, conservative treatment such as physical therapy often produces better results in the treatment of a herniated disc versus that of surgery or pain medications.

A physical therapist can help work with you to:

  • Reduce pain and other symptoms
  • Improve posture
  • Improve range of motion
  • Improve strength
  • Improve endurance
  • Learn an appropriate home exercise program
  • Return to pain-free activity

A recent Low Back Pain Survey conducted by the American Physical Therapy Association’s (APTA) “Move Forward” revealed:

  • Nearly 2/3 of Americans experience low back pain, but 37% do not seek professional help for pain relief.
  • Approximately 3/4 of Americans use pain medication as a way to relieve their symptoms
  • More that 1/3 of adults say low back pain has affected their ability to engage in tasks of daily living, exercise, and sleep
  • More than half of the participants reported experiencing low back pain throughout a majority of their work day while sitting – low back pain doesn’t only impact those who spend a majority of their time on their feet.

If you fear that you are at an increased risk for future low back pain or disc herniation, or if you have a history of low back pain – see your physical therapist today to address and/or prevent the problem.

American Physical Therapy Association –
Move Forward –

5 Reasons to Avoid Back Surgery

Instant impact, quick response, and immediate results are phrases everyone has gotten accustomed too in today’s day and age. With the human body however, it may not be that simple. Issues such as low back pain tend to develop over longer periods of time. If something happens over time it only makes sense that it would take a period of time to resolve.

When talking about back pain, surgery comes up more often than not. Most people may feel this is a quick and easy solution to their problem wanting immediate results. However, there are multiple reasons that this may not be the best option and is something that you should not rush into.

1. Conservative Treatments are Usually Effective

Low back pain will tend to improve over time as long as the body has time to heal. Conservative treatments such as therapeutic exercise, soft tissue massage, physical therapy, and manual physical therapy often increase the speed of recovery to relieve pain in a less invasive and less expensive manner.

2. Surgery is Expensive

Surgery is expensive. Once you add up imaging, surgeon cost, hospital costs, equipment, and medication the cost of a surgery can range from $100,000-$200,000. Depending on insurance coverage at the end of the process you could be left with a hefty bill, and the kicker is the surgery may not have been successful.

3. All Surgery comes with risk

When an individual goes for surgery all necessary precautions are always taken, with that said thought there are still inherent risks to surgery. Some of these risks include infection, blood clots, nerve damage, respiratory distress, stroke or heart attack. Most people come out of surgery with no side effects whatsoever, but the risks should make you think about surgery unless it’s absolutely necessary.

4. Long Period of Recovery Following Back Surgery

Depending on the procedure you may be unable to return to your normal way of life for weeks too months. Larger scale operations such as spinal fusions often take months to return to somewhat normal physical activity. During those initial days to weeks, you may need help getting in and out of a car, help showering, and need driven around due to the pain medication. You may never be able to return to full activity levels which will limit your functional ability and ability to complete your activities of daily living.

5. Surgery Doesn’t Always Solve the Problem

Where is your pain actually coming from? Is it a nerve or decreased joint space? What about poor posture or muscle imbalances? Maybe it’s actually deconditioning of your core and leg muscles. The point is, the back is complicated with multiple factors playing a role. It’s not always so cut and dry which is what makes back surgery a risk. In a study posted to WebMD “Almost 40% of patients in the study reported virtually no difference in back pain one year after having surgery”. It would be awful to go through the expense and recovery to then find out that you are still in the same pain you were before.

For these reasons, surgery should only be considered for the most severe or very specific cases. Really do your research before going into low back surgery to determine the best options for you and your pain.

Suffering With Back Pain? It Could Be Your Thighs…

Is back pain stopping you from being you? Causing you to suffer through activities that you love to do?

If so, you are not alone… over 80% of the population will suffer from back pain sometime in their lives! And it typically it gets worse as we get older.

As you sit around the table with your friends, co-workers, or family, you will discuss all kinds of reasons why people have back pain…

Arthritis…Genetics…Degenerative Changes…Bulging Disc/Herniated Disc.… the list goes on!

These are all great possibilities on what is going on INSIDE your spine. But most times these are not the CAUSE of the pain.

***If we’re going to get technical… Here’s the definition of the word CAUSE: make (something, typically something bad) happen.

The cause of the lower back issue isn’t typically what’s going on inside your back but something else around the back that could be putting too much pressure and force on the lower back resulting in pain.

If you want to find out the CAUSE of the back pain, take a look at your thighs (also known as the hip flexors).

I want to share with you a recent experience I had with a patient with chronic lower back pain that has been suffering for years. He had the X-Rays and MRIs. He went through physical therapy, chiropractors, masseuse, and acupuncture. All of these treatments were focusing on back flexibility and core strength.

“Bill” had pain across his lower back. He would suffer when he tried to stand up after sitting for a few minutes (he couldn’t stand up straight until he loosened up), he would have to lean over a grocery cart when he went shopping, and he was losing height because he was hunching over. The only time “Bill” had relief was when he was sitting or laying on his side.

After 10 minutes of the assessment, “Bill” came out and said he spent years behind the desk and he was a side sleeper. Light bulb just went off. He spent over 20+ hrs in the bent position. What could that mean?????

Check the HIPS!!!

Majority of the population are in the bent position for more than 15 hours a day!!!

How is that possible?

  • Side Sleeper: 8 hours
  • Eat breakfast Sitting: 30 minutes
  • Driving to Work: 30 minutes
  • Work: 4 hours
  • Eat lunch sitting: 30 minutes
  • Work: 4 hours
  • Drive Home: 30 Minutes
  • Eat dinner sitting: 30 minutes
  • Watch TV/Read book: 3 hours

TOTAL: 21 hours and 30 minutes!!!

So here’s the secret…

When you are in a bent position, your hip flexors (muscles that start from the spine and are stretched to the top of your thighs) are in a SHORT position.

As you stay in the bent position the muscle keeps getting shorter and shorter and tighter and tighter.

Then when we try to stand up straight, the hip flexors are too tight and pull on your lower back CAUSING more pressure and pain.

When you sit or hunch over that grocery cart, you put the muscles on slack and allow relief.

So here’s a super quick self-test…

  1. Do you get relief sitting?
  2. Do you get relief hunching over a grocery cart?
  3. Do you get pain when you try to stand up after sitting for a while or getting out of bed?
  4. Do you get pain standing for more than 10 minutes?
  5. Do you have a hard time standing straight up with good posture?

If you said yes to 3 out of the 5 questions, you have a good chance of having tight thighs!

Here at Hess Physical Therapy, we have low back specialists that specifically will look at the CAUSE of the lower back pain. We make sure to talk with you about specific activities that you are having pain with and go through a thorough examination to check the lower back and thighs that may CAUSE the lower back pain. The next step will be creating an individualized program to FIX the problem and get you on your way to feeling well again.

For more information on the programs that we offer to relieve your back pain, call us today! We are happy to chat with you about your back pain and how we can help start the process of getting you back to normal.